Pat,
Thank you for posting about this piece and giving me the opportunity to reread it. Quick personal update: My son Maayan, whose NICU experience I described, is now 27 years old (your math is not off, it took me a couple of years to write this up) and was married this summer. He was born small for gestational age, and is still small, but healthy, strong, robust, a joy.

Professional landscape update that Pat asked about is more complicated. NICU practices across the world (my son was born overseas, Lactnet is a global list) vary so widely. Even within country there is much variation in practice, knowledge and wisdom. In rereading this piece and remembering our NICU experience, I was surprised by how much things have changed and at the same time how much they are the same. The last 25+ years have brought much progress in the area of breastfeeding support, breastfeeding normalcy. The research is so ubiquitous and so compelling that rules and regulations requiring hospital LC support are much more common, in both NICUs and term nurseries. LLL has set a model and now has many sister organizations supporting breastfeeding in the community. Survival rates of smaller and smaller premature babies have brought with it the additional need for support services in the community for years after the babies return home. This is surely not true in the same way throughout the globe, but science, awareness and more equal access are growing.

The field of human milk banking is growing all over the world. It is one important aspect of infant health care and breastfeeding support, particularly for NICU babies.

There is also much work still to be done. For various reasons, breast milk feeding is becoming more prominent at the expense of breastfeeding. It seems sometimes that the support of scientific research about the importance of breast milk comes at the cost of understanding and supporting breastfeeding and its non scientific, non medical, less easily measurable value. Similarly, milk banking is a crucial service, but it brings with it the problem of the commodification of mothers' milk. In some ways, these are good problem to have, they point to much progress and success since my son was born in 1990. Time to address these new challenges.
What are the biggest challenges in your community, country, town? How can we best help and support one another to impact our local landscape?

Today (Oct 15) is Pregnancy and Infant Loss Remembrance Day.
November is Prematurity Awareness Month. What better time to take up this conversation together?

Naomi



Date:    Sat, 14 Oct 2017 12:01:12 -0400
From:    Patricia Young <[log in to unmask]<mailto:[log in to unmask]>>
Subject: Interesting read

Naomi Bar-Yam wrote about her NICU experience in 1994. Rx Breast Milk: One mother's experience in a NICU.  IJCE 9(1) 27-28.  A pathetic 3 weeks while her SGA baby caught up. They discarded her colostrum! I wonder how different NICUs are today compared to 1994......I can only hope that they are better.  I know they are different at CHOP.  How about your hospital?  Is your NICU trying to achieve NICU Baby Friendly?
------------------------------------------
Naomi Bar-Yam Ph.D.
Executive Director
Mothers' Milk Bank Northeast

President
Human Milk Banking Association of North America

[log in to unmask]<mailto:[log in to unmask]>
office: 617-527-6263
direct line: 617-340-3600
www.milkbankne.org
www.facebook.com/mmbne<http://www.facebook.com/mmbne>
@MMBNorthEast
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